Dr KK Aggarwal
Padma Shri Awardee
Dharma, Artha, Karma and Moksha are the four purposes of life; they are called the Four Purusharthas. Of these, dharma is the most important. The word dharma is derived from dhri, which means “to hold”. Therefore, it literally means “that which holds” i.e. anything which holds people together. Dharma changes according to circumstances, country, religion, community.
Values are our fundamental beliefs, which tell us what is right, good and just. Honesty, integrity, compassion, courage, honor, responsibility, patriotism, respect and fairness are examples of values.
Morals are values which we attribute to a system of beliefs, typically a religious system, but it could be a political system or some other set of beliefs.
Ethics are the principles that govern how we act and take decisions. Acting in ways, which are consistent with our beliefs, whether secular or derived from a moral authority is characterized as acting ethically.
Dharma is the path of righteousness and living one’s life according to the codes of conduct as described by the Vedas and Upanishads. Dharma of a doctor is to treat and save the life of a person at any cost.
The first code of conduct for doctors has been described in the Charaka Samhita “paro bhutadaya dharmamiti matva chikitsaya” i.e. “the physician has to consider compassion as the highest virtue, and proceed to treat patients”.
Then came the “pan-world” Hippocratic Oath, one of the oldest codes of conduct for doctors, which emphasizes self regulation.
The World Medical Association (WMA) also provides standards of ethical behavior for doctors around the world through its International Code of Medical Ethics, the Declaration of Geneva (the Physicians Pledge) and the Helsinki Declaration, which defines ethical principles for medical research involving human subjects.
All these codes propound self regulation. However, not all followed these self regulating standards. So, this brought on regulatory code of conduct with punitive provisions, MCI ethics, the Indian Penal Codes (IPC) and specific laws such as the PCPNDT Act with harsh penal provisions.
The root of these regulations with penal provisions is failure to self regulate.
If we don’t self regulate, then the government will bring laws. These laws will come with penal provisions and imprisonment.
Code of self regulation is made by the people themselves, who make up the individual Associations. The American Medical Association (AMA) Code of Medical Ethics is a classic example.
It’s high time that all stakeholders, including doctors’ association, pharmaceutical industry, health insurers, work out a common code of conduct.
FICCI Health Services Committee has taken an initiative to develop a comprehensive code of conduct, based on MCI Code of Ethics Regulations, Pharma Code of Conduct, IMA-NATHEALTH code.